A chalazion can resolve spontaneously.
The process may be helped by hot compresses, lid massage and lid hygiene measures like those that follow:
- Warm compresses to warm up and loosen secretions, twice daily. Try make-up cotton pads soaked in warm water and applied for about 10 minutes. There is a device called the EyeBag that does the same thing.
- Massage the lids, ‘milking’ the secretions out (downward movement on the upper lid and upward movement on the lower lid). Do this with clean fingers or cotton buds.
- Clean the lid margin by using warm water, previously boiled, mixed with either Johnson’s baby shampoo (it has to be Johnson’s due its formulation) or bicarbonate of soda. This needs to be done twice a day for at least 6 weeks.
Be aware that resolution often takes time and that several weeks of regular hot bathing may be required.
A small cyst which causes no symptoms can be safely left alone. A simple chalazion does not need treatment with antibiotics, even if it is very large.
If there is no improvement after 6 months, referral to a surgeon may be considered. Referral can be earlier if the chalazion is causing visual problems.
For adults, Oculoplastic consultant Mr Ahluwalia and Miss Metha run a nurse-led clinic (there is no nurse-led clinic for paediatric lid cyst).
Incision and curettage (or triamcinolone injection for suitable candidates) of chalazia should ONLY be undertaken if at least ONE of the following criteria have been met:
- Present for more than 6 months and has been managed conservatively with warm compresses, lid cleaning and massage for 4 weeks
- Interferes significantly with vision
- Interferes with the protection of the eye by the eyelid due to altered lid closure or lid anatomy
- Infection requiring medical attention twice or more within six months
- Infection causing abscess which requires drainage
- If malignancy (cancer) is suspected (eg madarosis/recurrence/other suspicious features, in which case the lesion should be removed and sent for histology as for all suspicious lesions